Epidemiology
Elevated Lp(a) independently predicts long-term in-stent restenosis in 1,209 Mayo Clinic PCI patients over nearly 9 years (Eur J Prev Cardiol 2024)
Original title: Lipoprotein(a) and long-term in-stent restenosis after percutaneous coronary intervention
In a multicentre retrospective study of 1,209 patients (mean age 65.9 years, 71.8% male) who underwent successful percutaneous coronary intervention at three Mayo Clinic sites between 2006 and 2017 and had preprocedural Lp(a) measured, patients were followed for a median 8.8 years. In-stent restenosis (ISR) occurred in 162 patients (13.4%). Median Lp(a) was significantly higher in patients who developed ISR than those who did not (27 vs. 20 mg/dL, P = 0.008), and ISR occurred more often in patients with high Lp(a), 50 mg/dL or above, than low Lp(a) (17.0% vs. 11.6%, P = 0.010). High Lp(a) independently predicted ISR (hazard ratio 1.67, 95% CI 1.18-2.37, P = 0.004), with the association becoming more pronounced beyond the first year after PCI. Lp(a) is an independent, long-term predictor of ISR and merits consideration when evaluating patients undergoing PCI.
Original abstract
Aims: Lipoprotein(a) [Lp(a)] has demonstrated its association with atherosclerosis and myocardial infarction. However, its role in the development of in-stent restenosis (ISR) after percutaneous coronary intervention (PCI) is not clearly established. The aim of this study is to investigate the association between Lp(a) and ISR.
Methods And Results: A retrospective study of adult patients who underwent successful PCI between January 2006 and December 2017 at the three Mayo Clinic sites and had a preprocedural Lp(a) measurement was conducted. Patients were divided into two groups according to the serum Lp(a) concentration [high Lp(a) ≥ 50 mg/dL and low Lp(a) < 50 mg/dL]. Univariable and multivariable analyses were performed to compare risk of ISR between patients with high Lp(a) vs. those with low Lp(a). A total of 1209 patients were included, with mean age 65.9 ± 11.7 years and 71.8% were male. Median follow-up after baseline PCI was 8.8 [interquartile range (IQR) 7.4] years. Restenosis was observed in 162 (13.4%) patients. Median serum levels of Lp(a) were significantly higher in patients affected by ISR vs. non-affected cases: 27 (IQR 73.8) vs. 20 (IQR 57.5) mg/dL, P = 0.008. The rate of ISR was significantly higher among patients with high Lp(a) vs. patients with low Lp(a) values (17.0% vs. 11.6%, P = 0.010). High Lp(a) values were independently associated with ISR events (hazard ratio 1.67, 95% confidence interval 1.18-2.37, P = 0.004), and this association was more prominent after the first year following the PCI.
Conclusion: Lipoprotein(a) is an independent predictor for long-term ISR and should be considered in the evaluation of patients undergoing PCI.
Summary written by lp-a.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.